THREAD on a quick Covid update (mainly England):

TLDR: two epidemics really - one in under 18s (and their parents) which is bad and getting worse and the other in everyone else which is getting better.
First - vaccine uptake in 12-15 year olds in England hasn't really started. With such high rates in teens right now this feels like a missed opportunity :-/

1/12
Looking at cases by date of test for each home nation, England and Wales are going up and NI and Scotland coming down. NI seems to be plateauing though.

England and Wales might be peaking (for now at least) 2/12
Positivity rates are hard to interpret right now... PHE surveillance shows positivity rates in symptomatic people is dropping a lot...

BUT there is also a big surge in rhinovirus (a cold) - with similar symptoms to Covid. 3/12
So if you feel grotty (sore throat, cough, runny nose, headaches) - it might well be this circulating cold OR Covid. Please do a Covid test to be sure!
4/12
So where are the cases? Central and Southern Scotland, most of Wales & central NI have high cases.
In England, cases are are higehest in Midlands and North.
Graph from @TravellingTabby 5/12
And who? 10-14 yrs way out in front, followed by older teens & 5-9 year olds. Next biggest group (& only other rising group) are their parents' generation - 30-59 yr olds.

A year ago we had big uni spike. Will we see it again? *hopefully* not with vax & prev infections. 6/12
And it's *not* just more testing of teens. ONS infection survey (always a few days behind cases) reported 4.6% of (randomly sampled) secondary school children tested positive week to 25 Sept. 1 in 21 children.

This is higher than it's ever been (just under 4% in late Dec).

7/12
Cases in 20 somethings dropping a lot and very low now - reaping the benefits of vaccination + some protection from previous infection too in unvaccinated. 8/12
Hospitalisations similar. Number of people in hospital falling in every nation now (good) 9/12
The drop is mainly driven by declines in 18-84 yr olds. The only age group where hospital admissions are significantly climbing now (although low in absolute nums) are 6-17 year olds - school age kids.

1,744 6-17 yr olds have been admitted with Covid since 1 July. 10/12
The biggest hotspot right now is Kettering - over 6% of their 10-14 year olds tested positive in the last week!
Rates in 40-49 yr olds are higher than they've ever been...
It should peak soon in kids, but at the cost of so many infections... just as vax is starting. 11/12
should have said *relatively* very low. 200/100K/week still quite high!
We should have kept protections in schools. We should restore them now! Masks & contact tracing in secondary schools... Ventilation! Where are the promised CO2 monitors? And the support to act on their readings if too high? Govt has had months to prepare & done so little. 12/12
PS on getting a PCR test with symptoms that are not the "classic (outdated) triad" of temp, cough, loss of smell/taste (so e.g. sore throat, runny nose, headache) -> can get one after positive LFD test, or through logging yr symptoms on the Zoe symptom tracker app.

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More from @chrischirp

Oct 19
Important 🧵on our new peer-reviewed paper:

The pandemic is as bad as it ever was for babies - in year to Aug 2023, 6,300 babies under 1 were admitted to hospital wholly or partly BECAUSE of Covid.

They are ONLY age group where admissions have NOT gone down over time 1/17 Image
Our study, led by Prof @katebrown220, looked at all hospitalisations in England in children with a Covid diagnosis or positive test from Aug 2020-Aug 2023.
We then *excluded* all admissions where a Covid diagnosis was incidental (ie not why they were in hospital)
2/17 Image
Infants (babies under 1) are generally at higher risk from respiratory infections, plus they are the age group that, if infected, are overwhelmingly meeting the virus for the first time.

They are not vaccinated and have not had it before. 3/17
Read 18 tweets
Sep 26
Prof @Kevin_Fong giving the most devastating and moving testimony to the Covid Inquiry of visiting hospital intensive care units at the height of the second wave in late Dec 2020.

The unimaginable scale of death, the trauma, the loss of hope.
Please watch this 2min clip.
And here he breaks down while explaining the absolute trauma experienced by smaller hospitals in particular - the "healthier" ICU patients were transferred out, leaving them coping with so much death.

They felt so alone.
Here Prof Fong explains how every nurse he met was traumatised by watching patients die, being only able to hold up ipads to their relatives and how it went against their normal practice of trying to ensure a dignified death, with family there.
Read 5 tweets
Aug 28
THREAD: I asked what the point of Public Inquiries is for @bmj_latest

We've spent hundreds of millions of £ on Inquiries over last decades, generating deep understanding of failures & 1000s of recommendations.

But v few recommendations get implemented!
What is going on?

1/12 Image
E.g. Covid-19 Inquiry has cost £94 million so far - and is projected to cost over £200m by its end (it still has years to go).

1st report published (out of at least 9) found major flaws and proposed 10 recommendations.

Chances are low that they will be implemented :-( 2/12


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Inst for Government looked at 68 Inquiries from 1990-2017.
The Inquiries cost over £630 million and made 2,625 recommendations.

Only 6/68 Inquiries have received full scrutiny by a parliamentary select committee on implementation of recommendations. 3/12 Image
Read 12 tweets
Aug 9
🧵War causes direct civilian deaths but also indirect deaths over the following years.

Recent paper estimates eventual total direct & indirect deaths in Gaza attributable to the war - 10% of entire pop'n.

I want to explain these estimates and why deaths must be counted. 1/13 Image
Why count casualties from war anyway? For moral, legal and strategic reasons.

1 - owe it to those who have died
2 - International law says must count & identify dead as far as possible
3 - monitor progress of war & learn from tactics

2/13 Image
There are direct and indirect casualties of war. Direct deaths include those who killed by fighting or bombs.

Indirect deaths are those that die when they would otherwise have lived because of one or more of: lack of food, healthcare, housing, sanitation, income, hope. 3/13 Image
Read 14 tweets
Aug 1
THREAD: the summer Covid wave in the UK continues.
Basically, there is a LOT of Covid around and not a lot of other respiratory viruses.

If you have cold or flu symptoms, it's probably Covid.

The latest hospital data from England shows steady, quite high levels. 1/8 Image
But admissions don't tell us how much virus is circulating more generally. The best (but imperfect) measure we have is wasterwater measurements, and only in Scotland and not England.

Scotland's wastewater is showing a huge July peak - highest since Omicron's 1st yr in 2022 2/8 Image
Because different people shed different amounts of virus and variants can matter too, you can't for sure infer how many people were infected between different wasterwater peaks. BUT given the size, I'd say it's pretty likely this is the largest peak since 2022 in Scotland 3/8
Read 8 tweets
Jul 23
THREAD:
I wrote about Baroness Hallett's Inquiry Module 1 report for @bmj_latest .

She found that there was *never* a plan to keep a pandemic death toll down - I discuss this and what it means going foward.

Main points below: 1/14 Image
The headline most seen is that the UK planned for the wrong pandemic.

While it is true that was far too narrow a focus on a flu pandemic, that is not the most telling bit.

To me the most telling bit, is what the plan did NOT do 2/14


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The issue is less the wrong disease, but that there was never a plan to prevent one at all – of any disease type.

The plan was *never* about reducing the number of pandemic deaths. 3/14 Image
Read 14 tweets

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